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Kasich Wins Approval of Medicaid Plan That Bypasses Legislature

Ohio Governor John Kasich
Governor John Kasich, an Ohio Republican, speaks at the Republican National Convention in Tampa, Florida on August 28, 2012. Kasich said Ohio has a moral duty to help people without health insurance, especially those with mental illnesses and drug addictions. Photographer: Brian Cassella/Chicago Tribune/MCT via Getty Images

Oct. 21 (Bloomberg) -- An Ohio legislative panel approved Governor John Kasich’s plan to expand Medicaid under President Barack Obama’s health-care overhaul over the protests of fellow Republicans in the House of Representatives.

The Ohio Controlling Board, a separate legislative entity that considers agencies’ spending requests, voted 5-2 today to take $2.56 billion in U.S. funds through fiscal 2015 to add 275,000 adults to the state-federal program for the poor.

Kasich, a first-term governor, turned to the panel to circumvent a vote of the full legislature after he was unable to persuade Republicans who control it. Almost two-thirds of the 60 Republican representatives, including Speaker William Batchelder, protested his Controlling Board gambit as illegal and unconstitutional.

“This offers an opportunity to really give people a hand up,” Tracy Plouck, director of the Ohio Department of Mental Health representing the Kasich administration, told the panel.

The board consists of four Republican and two Democratic lawmakers, plus a chairman from the state budget office named by Kasich.

Under the Affordable Care Act, states can expand Medicaid to cover those earning about a third more than the federal poverty level, or $15,856 annually for an individual and $26,951 for a family of three this year, according to the Kaiser Family Foundation, a Menlo Park, California-based nonprofit that studies health issues. It said Ohio will be the 25th state, and the eighth with a Republican governor, to take that step. The U.S. government will pay all the added cost for the first three years and at least 90 percent after that.

Hard Hearted?

Kasich said expansion will bring about $13 billion from the federal government over seven years. He also said the state has a moral duty to help people without health insurance, especially those with mental illnesses and drug addictions.

“Why is that some people don’t get it?” Kasich asked during an Oct. 18 event at the Cleveland Clinic promoting the expansion. “Is it because they’re hard-hearted or cold-hearted? It’s probably because they don’t understand the problem because they have never walked in somebody’s shoes.”

The Cleveland Clinic, one of the world’s foremost medical and research centers, said last month it is cutting $330 million from its $6 billion annual budget in 2014 because of rising expenses and other changes in health care. About half of the cuts are in response to the Affordable Care Act, spokeswoman Eileen Sheil said by phone.

Triple Win

Even so, the clinic, which is the largest provider of Medicaid services in northern Ohio, is supporting Kasich’s plan because it will mean patients otherwise treated in emergency rooms will get faster and cheaper care, said Linda Bradley, a doctor of obstetrics and gynecology.

“It is the right decision from both the medical, economic and moral perspective,” Bradley said during the Oct. 18 event with Kasich.

Ohio Republicans, like their fellow party members nationally opposed to the health-care law, objected to the additional spending and expanding what they said is a flawed program.

A protest letter signed by Batchelder and 38 other House Republicans said Kasich’s action violates the state constitution and law by skirting a full vote of the General Assembly and ignoring its intent not to expand Medicaid.

Kasich told reporters in Cleveland that he has been assured by his legal counsel that the Controlling Board action is proper.

Into Court

A legal challenge is inevitable, said Jon Allison, a Columbus attorney leading a coalition of hospitals and other state businesses supporting expansion.

“Given the intensity of feelings on all sides of this issue, it does not surprise me that this would end up in court,” Allison, a chief of state to former Ohio Governor Bob Taft, said on a Oct. 17 conference call with reporters.

While Ohio Tea Party groups have said they won’t back Kasich’s re-election next year because of his stance on Medicaid, the governor said he can’t let politics decide the issue.

“This is the right thing for our state, and most important for our people who live in the shadows,” Kasich said.

To contact the reporter on this story: Mark Niquette in Columbus at

To contact the editor responsible for this story: Stephen Merelman at

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